Mississippi is the worst state to live in because it ranks last in a number of important measures that determine overall quality of life in a state. The state’s life expectancy of 74.9 years is the lowest of all states and more than 4 years below the U.S. life expectancy. The state’s poor life expectancy likely is in part due to suboptimal access to and quality of healthcare. The state also has the fewest primary care physicians per capita. It also has the third highest rate of preventable hospitalizations.

Poor health outcomes are far more likely to occur in low-income areas, and no state has a higher share of residents living in poverty than Mississippi. Some 19.8% of state residents live below the poverty line, compared to the 13.4% national poverty rate.

In West Virginia, only one in five adults have a bachelor’s degree, the smallest share of any state. Higher educational attainment can improve a person’s likelihood of attaining a higher-paying job and financial security. Studies have shown that college-educated people are more likely to live healthier lives. In West Virginia, 35.5% of adults are obese, a far greater obesity rate than the national rate of 28.0% and the highest of any state. Nearly one-quarter of state adults smoke, also the highest state rate.

Financial hardship is also very prevalent in West Virginia. About 19.1% of the state population lives in poverty — the fourth highest poverty rate of all states. The state’s annual median household income of $43,469 also is well below the national figure of $60,336 and is the lowest nationwide. Lower incomes in West Virginia are due partially to the state’s weak job market. In 2017, 5.2% of West Virginia’s labor force was out of a job, the third highest annual unemployment rate of all states.

Louisiana ranks as the third worst state to live in largely due to the state’s poor economic conditions, as evidenced by its high poverty rate. With a poverty rate of 19.7%, the state’s rate is tied with New Mexico’s for second highest in the country. Louisiana residents are also more likely to live in extreme poverty than those in any other state. Some 6.6% of families in the state earn less than $10,000 a year.

While the relationship between income and crime is complicated, areas with higher poverty rates tend to also have higher levels of violent crime. There is a strong correlation between poverty and crime, and Louisiana is one of the most dangerous states. It has one of the highest annual violent crime rates at 557 reported incidents per 100,000 citizens each year. Comparatively, the U.S. violent crime rate is 383 reported incidents per 100,000 people. Violent crime has been shown to affect not just the direct victims, but the community at large, causing stress and making neighborhoods less desirable for businesses.

Compared with residents in other states, Alabama’s population is much more likely to struggle financially. The median household income in Alabama of $48,123 a year is one of lowest in the nation. For perspective, the national median household income is $60,336. Also, nearly 17% of Alabama’s population lives in poverty, the sixth highest poverty rate among all states.

Income is closely tied with health outcomes. In part due to the state’s high poverty rate, Alabama’s population is one of the least healthy in the nation, contributing to its rank as fourth worst state to live. An average Alabama resident born today is projected to just barely live over 75 years, the second shortest life expectancy in the nation.

One of the reasons Kentucky ranks as the fifth worst state to live in is its high poverty rate. The state’s median household income of $48,375 a year is nearly $12,000 lower than the U.S. median. Of the state’s 4.5 million residents, 17.2% live in poverty, the fifth highest poverty rate of all states. Kentucky also has the fifth highest extreme poverty rate, as 5.6% of Kentucky families earn less than $10,000.

Another factor pushing Kentucky toward the bottom of the rankings is life expectancy. A person born in Kentucky today can be expected to live an average of 76.3 years, nearly three years shorter than the average American.